JNM
J Neurogastroenterol Motil, Vol. 16 No. 2 April, 2010
DOI: 10.5056/jnm.2010.16.2.186
Journal of Neurogastroenterology and Motility
Original Article
The Differences in Prevalence and
Sociodemographic Characteristics of Irritable
Bowel Syndrome According to Rome II and
Rome III
Dong Won Park, MD, Oh Young Lee, MD*, Sung Gon Shim, MD, Dae Won Jun, MD, Kang Nyeong Lee, MD, Hye Young
Kim, MD, Hang Lak Lee, MD, Byung Chul Yoon, MD, and Ho Soon Choi, MD
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea
ㅋ
Background/Aims
Irritable bowel syndrome (IBS) is one of the most frequently observed disorders by primary care and practitioners. The aim of
this study was to estimate the prevalence of IBS using the Rome II and III criteria in the general Korean population and also
to compare sociodemographic differences between subjects diagnosed by these criteria.
Methods
Telephone interview surveys were performed with a total of 1,009 individuals in Korea, 15 years of age or older. The questionnaire, based on the Rome II and III criteria, was validated.
Results
Among the 1,009 subjects, the prevalence of IBS was 8.0% under the Rome II criteria (81 subjects; 6.4%, male; 9.6%, female), and 9.0% (91 subjects; 7.0%, male; 11.0%, female) under the Rome III criteria. The accordance rate of Rome II and
III was 73.5%. Both groups showed highest frequency in the age of 30s (13.9% vs. 15.3% respectively). Female subjects
showed a higher prevalence than male subjects under Rome III (91 subjects; 11.0% in female, 7.0% in male; p < 0.05), but
not under Rome II criteria. Many patients older than 50 years were added when analyzed under the Rome III criteria, but not
under the Rome II criteria (p = 0.017).
Conclusions
The Rome III criteria were less restrictive and showed good agreement with the Rome II criteria. The prevalence of IBS was
increased in young women.
(J Neurogastroenterol Motil 2010;16:186-193)
Key Words
Prevalence, Irritable bowel syndrome, Rome II, Rome III
Received: December 28th, 2009 Accepted: April 7th, 2010
CC This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.
org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work
is properly cited.
*Correspondence: Oh Young Lee, MD
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hanyang University, 17 Haengdang 1-dong,
Seongdong-gu, Seoul 133-071, Korea
Tel: +82-2-2290-8354, Fax: +82-2-2298-9183, E-mail: [email protected]
Financial support: None.
Conflicts of interest: None.
186
ⓒ 2010 The Korean Society of Neurogastroenterology and Motility
J Neurogastroenterol Motil, Vol. 16 No. 2 April, 2010
www.jnmjournal.org
Difference in Prevalence and Characteristics of IBS
Introduction
M aterials and M ethods
Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal discomfort or pain is associated with
1-3
defecation or a change in bowel habit. IBS is one of the most
frequently observed disorders in primary care and gastroenterology practices and accounts for 29.8 percent of visits due to
4-6
gut problems. Although the clinical importance of IBS has increased, there is no biochemical or physiological indicator for diagnosis of IBS. In view of increasing diagnostic accuracy, the
Rome III criteria have been suggested as standardized diagnostic
7-12
criteria for IBS.
In 1978, Manning published the first symptom-based diag7,13,14
However, the Manning criteria had
nostic criteria for IBS.
no provision for frequency or duration of symptoms and had no
15
diagnostic value for men. Since an international expert working
team first presented criteria for Rome I in 1988, the definition of
IBS has changed. In 2006, the Rome III criteria were pro7-12
posed. There were several changes from the Rome II to the
Rome III criteria. A distinctive difference between the Rome II
and III criteria is timeframe. Unlike with the Rome II criteria,
symptoms must have originated 6 months prior to diagnosis, be
currently active, and have been active for the past 3 months, in the
Rome III criteria. Furthermore, the Rome III criteria applied
simple classification derived from stool consistency to categorize
8-10
IBS.
Previous studies have reported that the prevalence of IBS
8,12,16-20
varies according to revisions of diagnostic criteria for IBS.
Many studies have assessed that the overall prevalence of IBS as
up to approximately 25% using the Manning and the Rome cri12,21,22
To date, the prevalence of IBS in Korea
teria worldwide.
using the Rome II criteria has been estimated as ranging from
23,24
Many studies about diagnostic criteria for
6.6% to 16.8%.
IBS have been performed since the publication of the Rome III
criteria. However, there are few studies regarding the prevalence
23,24
of IBS diagnosed by the Rome II criteria in Asian countries,
and the Rome III criteria have only recently been published to diagnose and classify IBS. Moreover, only a few studies have com8,18
pared the Rome II and III criteria for IBS, worldwide.
The aim of this study was to estimate the prevalence of IBS
using the Rome II and III criteria in the Korean general population and also to compare sociodemographic differences among
the subjects diagnosed by these criteria.
1. Sampling procedures
The telephone interview survey was performed by Gallup,
based in Korea, using a reliable and validated questionnaire based
on the Rome II and III criteria (Korean version). A random sample of telephone numbers in nationwide scale was selected from
the 8 districts of South Korea. The questionnaire was administered to 1,009 subjects age 15 or over, evenly distributed by
gender and age, and a random digit dialing sample was obtained
using the Kish sampling procedure.
2. Recruitment, questionnaire, and validation
The interviewer explained the aim of our study to all eligible
individuals and asked individuals to participate in a survey about
IBS and other functional bowel diseases. All respondents gave
the interviewer verbal informed consent prior to participation in
the survey, and the telephone interview survey was performed by
the interviewer, who had been trained by a gastroenterologist.
The questionnaire, containing 22 response items, consisted
of several general questions (gender, age, region, education,
household income, and occupation) and more specific questions
associated with diagnosis of IBS and other functional bowel disorders using the Rome II and III criteria. Among the questions,
15 questions were used for these studies. Respondents with a history of chronic illness, such as colon cancer, colitis, inflammatory
bowel disease, hemorrhoids, diabetes, liver disease, or heart disease, as well as pregnant subjects, were excluded from the telephone survey.
The questionnaire, using the Rome II and III criteria, was
translated into Korean, in accordance with guidelines suggested
25
by Guilleman et al. The translation was conducted by 2 translators and back-translated into English by 2 other translators. If
the subject refused to answer the questionnaire, the telephone interview was discontinued. The total interview took approximately
20 minutes. The response rate of the telephone interview survey
was 20.2% (n = 1,009). The study was approved by the Hospital
Ethical Committee for Clinical Investigations.
3. Definition
Subjects responded to the questionnaire based on the Rome
II and III criteria. For a diagnosis of IBS to be made, the subject
needed to have at least 2 of the following 3 symptoms: (1) relief
Vol. 16, No. 2 April, 2010 (186-193)
187
Dong Won Park, et al
with defecation, and/or (2) onset associated with a change in frequency of stool, and/or (3) onset associated with a change in appearance of stool. Subjects diagnosed using the Rome III criteria
have abdominal discomfort or pain at least 3 days/month in the
last 3 months, and subjects diagnosed using the Rome II criteria
have abdominal discomfort or pain for at least 12 weeks, which
7-10
need not be consecutive, in the preceding 12 months.
For the purpose of classifying the subtype of IBS, all subjects
diagnosed with IBS using the Rome II and Rome III criteria
were asked for their stool form based on the Bristol Stool Form
9
Scale, proposed by the Rome III criteria. According to the Bristol
Stool Form Scale, we classified all IBS patients into IBS with constipation (IBS-C)- hard or lumpy stools ≥ 25% and mushy or
watery stools < 25% of bowel movement; IBS with diarrhea
(IBS-D)- mushy or watery stool ≥ 25% and hard or lumpy
stools ＜ 25% of bowel movements; Mixed IBS- hard or lumpy
stools ≥ 25% and mushy or watery stools ≥ 25% of bowel
movements; Unsubtyped IBS- insufficient abnormality of stool
consistency to meet criteria for IBS-C, D or mixed IBS.
Subjects fulfilling the Rome II diagnostic criteria were also
classified into subtypes using the Bristol Stool Form Scale. So we
compared IBS subtypes using Rome III criteria to IBS subtypes
using the ‘adjusted’ Rome II criteria.
4. Statistical methods
Statistical analyses were performed using a SPSS package
version 12.0. All data were presented as frequency and percent2
age for categorized variables using the χ test. If 1 or 2 of the cells
in a two-by-two contingency table had numbers less than 5, the
Fisher’s exact test was used. The agreement between 2 diagnostic
criteria defining the subjects was assessed using Cohen’s κ
statistics. Values for κ score represented ≥ 0.81 very good agreement, 0.61-0.80 good agreement, 0.41-0.60 moderate agreement,
0.21-0.40 fair agreement, and ＜ 0.21 poor agreement. The respective 95% confidence intervals for the rates were calculated.
Values of p ＜ 0.05 were considered to be statistically significant.
Results
The response rate of the telephone survey was 26.2% (n =
1,009). These respondents, aged 15 or more (range 15-87), were
stratified by gender and age. The mean age of our population was
41.1 ± 16.8 years (male 40.0 ± 17.4 vs. female 42.2 ± 16.2, not
significant), and 49.7% of the respondents were male. The basic
characteristics of respondents are shown in Table 1.
188
Table 1. Baseline Characteristics
Gender
Male
Female
Age (yr)
≥ 15-< 30
≥ 30-< 40
≥ 40-< 50
≥ 50
Region
Seoul
Incheon/Kyungi
Kangwon
Taechon/Chungchung
Kwangju/Junla
Teaku/Kyungbuk
Pusan/Ulsan/Kyungnam
Cheju
Education
< High school
High school graduate
> High school
Household income
≤ National income
> National income
Unknown
Occupation
Farming/Forestry/Fishery
Independent enterprise
Blue collar worker
White collar worker
Housewife
Student
Unemployed
Total
n
%
501
508
49.7
50.3
289
202
217
301
28.6
20.0
21.5
29.8
216
268
32
99
111
111
161
11
21.4
26.6
3.2
9.8
11.0
11.0
16.0
1.1
318
345
346
31.5
34.2
34.3
341
499
169
33.8
49.5
16.7
58
103
112
120
292
191
133
1,009
5.7
10.2
11.1
11.9
28.9
18.9
13.2
100.0
1. Prevalence of IBS
The prevalence of the Rome II and III diagnostic criteria according to sociodemographic characteristics are indicated in Table
2. Of the 1,009 respondents (male, n = 501; female, n = 508),
81 individuals fulfilled the Rome II criteria for diagnosis of IBS
(8.0%): 32 male subjects (6.4%) and 49 female subjects (9.6%).
Among the subjects diagnosed by the Rome II criteria, female
subjects tend to have a higher prevalence of IBS than male
subjects. However, there is no significant difference (p = 0.057)
between genders. Of the 1,009 respondents, 91 subjects (9.0%)
meet the Rome III criteria: 56 female subjects (11.0%) and 35
male subjects (7.0%), with a significantly higher prevalence in fe-
Journal of Neurogastroenterology and Motility
Difference in Prevalence and Characteristics of IBS
48 (9.6)
54 (10.8)
499
13 (7.7)
11 (6.5)
169
4 (6.9)
3 (5.2)
58
11 (10.7)
14 (13.6)
103
of IBS according to the Rome III criteria, but not the Rome II
criteria.
According to Rome II criteria, the prevalence of IBS is highest (15%, 19 women of 127 subjects) in women age 15-29, while,
according to Rome III criteria, the prevalence of IBS is highest
(14%, 16 women of 114 subjects) in women age 30-39. For men,
the prevalence of IBS is highest in those age 30-39 under both
Rome II and Rome III (15.9%, 14 men and 17%, 15 men of 88
subjects, respectively) criteria (data not shown).
In this study, subjects with IBS were divided into 2 groups
based on household income: above the national average or below
the national average. Subjects with incomes above the national
average have a significantly higher prevalence of IBS than subjects below the national average under the Rome II criteria (p =
0.05). However, under the Rome III criteria, there was no statistically significant difference (p = 0.121).
When the agreement rate (Table 3) was assessed using κ statistics between the 2 sets of Rome diagnostic criteria for IBS patients (Rome II vs. III), there was a good agreement regarding
the prevalence of IBS based on the diagnostic criteria (κ score =
0.733). Among patients with IBS, as determined by the Rome II
critieria, 65 subjects (6.4%) fulfill the Rome III criteria. In total,
107 subjects (10.6%) were diagnosed with IBS using the Rome
II or the Rome III criteria.
9 (8.0)
11 (9.8)
112
2. Subtypes of IBS and the Rome diagnostic criteria
13 (10.8)
15 (12.5)
120
24 (8.2)
14 (7.3)
6 (4.5)
81 (8.0)
29 (9.9)
9 (4.7)
10 (7.5)
91 (9.0)
We categorized all IBS diagnosed with the Rome II and III
criteria into four subtypes based on the Bristol Stool Form Scale.
We note high proportions of IBS-C using the Rome III criteria
and using the ‘adjusted’ Rome II criteria (Table 4). Of the 49 female subjects diagnosed with IBS using the ‘adjusted’ Rome II
criteria, 19 subjects (38.8%) were included in the IBS-C group.
However, there is no significant gender difference between the
groups when using the ‘adjusted’ Rome II criteria (p ＞ 0.05).
Table 2. Prevalence of Irritable Bowel Syndrome by Sociode-
mographic Characteristics According to the Rome II and III
criteria
Gender
Male
Female
Age (yr)
≥ 15-＜ 30
≥ 30-＜ 40
≥ 40-＜ 50
≥ 50
Education
< High school
High school
graduate
> High school
Household income
≤ National
income
> National
income
Unknown
Occupation
Farming/
Forestry/Fishery
Independent
enterprise
Blue collar
worker
White collar
worker
Housewife
Student
Unemployed
Total
Rome II
n (%)
Rome III
n (%)
Subjects
(n)
32 (6.4)
49 (9.6)
35 (7.0)
56 (11.0)
501
508
28 (9.7)
a
28 (13.9)
15 (6.9)
10 (3.3)
23 (8.0)
a
31 (15.3)
20 (9.2)
17 (5.6)
289
202
217
301
18 (5.7)
26 (7.5)
20 (6.2)
25 (7.2)
318
345
37 (10.7)
46 (13.3)
346
20 (5.9)
26 (7.6)
349
c
b
d
292
191
133
1,009
a
p ＜ 0.05 when compared to difference among age distributions of irritable
bowel syndrome (IBS) (in Rome II and III, respectively), bp ＜ 0.05 when
compared to difference among educational levels of IBS (in Rome III), cp = 0.05
when compared to difference among income of IBS (in Rome II), dp = 0.121
when compared to difference among income of IBS (in Rome III).
male subjects (p = 0.025). The prevalence of IBS based on age
distribution according to the Rome II criteria is significantly
higher among those in their 30s (p = 0.001). Similarly, according to Rome III criteria, the prevalence of IBS based on age distribution is significantly higher among those in their 30s (p =
0.004). The higher the education level of the respondents, the
more frequent the occurrence of IBS (Rome II criteria). Higher
education level is significantly correlated with a higher prevalence
Table 3. Agreement Between the Two Ways to Define Irritable
Bowel Syndrome Based on the Diagnostic Criteria
Rome III (n)
Rome II (n)
IBS
Non-IBS
Total
IBS
Non-IBS
Total
65
26
91
16
902
918
81
928
1,009
IBS, irritable bowel syndrome.
κ Score = 0.733, p ＜ 0.001.
Vol. 16, No. 2 April, 2010 (186-193)
189
Dong Won Park, et al
Table 4. Proportion of IBS Subtype by Gender According to the ‘Adjusted’ Rome II and III criteria
‘Adjusted’ Rome II
IBS-C
IBS-D
IBS-M
IBS-U
Total
Rome III
Male
n (%)
Female
n (%)
Total
n (%)
11 (34.4)
11 (34.4)
7 (21.9)
3 (9.4)
32 (39.5)
19a (38.8)
11 (22.4)
14 (28.6)
5 (10.2)
49 (60.5)
30 (37.0)
22 (27.2)
21 (25.9)
8 (9.9)
81 (100.0)
Male
n (%)
11 (31.4)
11 (31.4)
8 (22.9)
5 (14.3)
35 (38.5)
a
Female
n (%)
Total
n (%)
22b (39.3)
16 (28.6)
12 (21.4)
6 (10.7)
56 (61.5)
33 (36.3)
27 (29.7)
20 (22.0)
11 (12.1)
91 (100.0)
b
p ＞ 0.05 when compared to difference between gender distributions of IBS in ‘adjusted’ Rome II, p ＞ 0.05 when compared to difference between gender distributions
of IBS in Rome III.
IBS, irritable bowel syndrome; IBS-C, irritable bowel syndrome with constipation; IBS-D, irritable bowel syndrome with diarrhea; IBS-M, mixed irritable bowel
syndrome; IBS-U, unsubtyped irritable bowel syndrome.
Table 5. Proportion of Irritable Bowel Syndrome by Sociodemographic Characteristics in Group A, B, and C
Figure 1. Schematic representation of the groups fulfilling both the
Rome II and III criteria. Group A, subjects fulfilling the Rome II
criteria but not the Rome III criteria; Group B, subjects fulfilling
both the Rome II and Rome III criteria; Group C, subjects fulfilling
the Rome III criteria but not the Rome II criteria.
Similarly, there is no significant difference in the prevalence of
IBS between male and female subjects according to the Rome III
criteria (p ＞ 0.05).
Age (yr)
≥ 15-＜ 30
≥ 30-＜ 40
≥ 40-< 50
≥ 50
Mean
Education
< High school
High school
graduate
> High school
Household income
≤ National income
> National income
Unknown
Group A
n (%)
Group B
n (%)
Group C
n (%)
11a (68.8)
2 (12.5)
0 (0.0)
3 (18.8)
30.7
17 (26.2)
26 (40.0)
15 (23.1)
7 (10.8)
37.1
6 (23.1)
5 (19.2)
5 (19.2)
10b (38.5)
44.4
6 (37.5)
6 (37.5)
12 (18.2)
20 (30.8)
8 (30.8)
5 (19.2)
4 (25.0)
33 (50.8)
13c (50.0)
4 (25.0)
6 (37.5)
6 (37.5)
16 (24.6)
42 (64.6)
7 (10.8)
10 (38.5)
12d (46.2)
4 (15.4)
a
3. IBS subgroups and Rome diagnostic criteria
A schematic representation of subgroups according to the
Rome criteria is shown in Figure 1. Group A is comprised of 16
subjects (1.6%) who met the Rome II criteria but not the Rome
III criteria and Group C is comprised of 26 subjects (2.6%) who
met the Rome III criteria but not the Rome II criteria. Of all
1,009 respondents, the 65 subjects (6.4%) who fulfilled both the
Rome II and III criteria are designated as Group B. Table 5 includes the proportion of IBS subgroups by sociodemographic
characteristics.
In Group A, the mean age is 30.7 years, and the proportion of
IBS was significantly high in their age 15-29. In Group C, the
mean age is 44.4 years old, with 57.7% of them older than 40
years of age. As the diagnostic criteria of IBS has changed from
190
p = 0.001 when compared with subjects in group B, bp = 0.017 when compared
with subjects in group B, cp ＞ 0.05 when compared with subjects in group B, dp
> 0.05when compared with subjects in group B.
IBS, irritable bowel syndrome; Group A, subjects fulfilling the Rome II criteria
but not the Rome III criteria; Group B, subjects fulfilling both the Rome II
criteria and Rome III criteria; Group C, subjects fulfilling the Rome III criteria
but not Rome II criteria.
the Rome III to the Rome III, those older than 50 years are increased, significantly (p = 0.017).
The higher education level of subjects in group B, the more
frequent occurrence of IBS. However, there is no significant relationship between educational level and frequency of IBS in subjects in group A and C, compared with those in group B. The
proportion of subjects above the national income is relatively
higher in all groups, whereas the results are not significant (p ＞
Journal of Neurogastroenterology and Motility
Difference in Prevalence and Characteristics of IBS
0.05).
D iscussion
The prevalence of IBS varies enormously depending on the
diagnostic criteria employed. In a study of 2,000 individuals in
Spain, the prevalence values obtained using the Rome II criteria
were lower (3.3%) than those obtained using the Manning and
19
the Rome I criteria (10.3% and 12.1%, respectively). Several reports using the Rome I criteria showed that the prevalence of IBS
ranged from 9.5% to 15.0%, whereas the studies using the Rome
II criteria showed that the prevalence of IBS ranged from 2.3% to
16,17,20
These studies from around the world using the Rome
6.9%.
criteria reveal that the prevalence is lower when using the Rome
II criteria than when using the Manning and Rome I criteria.
A recent report of 10,000 Israeli adults showed that the prevalence of IBS is significantly higher using the Rome III criteria,
8
as compared with the Rome II criteria (11.4% vs. 2.9%). The
prevalence rate of IBS by the Rome II criteria was unexpectedly
low, and subjects diagnosed with IBS by the Rome II criteria had
higher consultation rates. Additionally, IBS patients diagnosed
by the Rome II criteria had chronic symptoms (at least 12 weeks
over 12 months). The complexity of the disease and the extended
time frame make recalling symptoms difficult, especially for older
individuals. The Rome III criteria are easier and more understandable for elderly population.
In the present study, the prevalence for IBS was higher by
the Rome III criteria, as compared with the Rome II criteria, and
the age distribution shifted to the right. These results reflect variation in IBS prevalence, depending on different diagnostic
criteria.
In general, we found that IBS prevalence is higher in women
than men. There are several potential reasons for the gender
difference. For example, in women, IBS may be associated with
an antinociceptive mechanism minimizing pain related to pelvic
26
events (e.g., pregnancy and delivery). Additionally, gender dif27
ferences affect serotonin synthesis in brain, and female sex hor28,29
mones affect gastrointestinal motility in female IBS patients.
However, other studies have shown that gender distribution var30
ies according to socioeconomic status by nation. Drossman et al.
reported that the IBS prevalence using the Rome criteria was
14.5% in women and 7.7% in men among U.S. households.
Similarly, the prevalence of IBS among Japanese and Dutch
women (31% and 21%, respectively) was higher that than among
31
men (23% and 7%, respectively). On the other hand, a study
with 2,486 adults in Beijing showed no gender difference be29
tween men and women (1 vs. 1.15), and in Hong Kong and
Singapore, the prevalence of IBS using the Rome II criteria was
32,33
Moreover in
not markedly higher in women than in men.
India, a study of 2,000 subjects showed that IBS prevalence is
34
higher in men than in women (7.9% vs. 6.9%). Interestingly, we
previously reported that the prevalence of IBS was 6.6%, and
there was no gender difference in IBS prevalence (7.1%, male;
6.0%, female) 5 years earlier using the Rome II criteria. However,
in our present study, female subjects showed a higher IBS prevalence than male subjects under the Rome II and III criteria. The
most striking difference between our previous study and this current study is the change of occupational status among women in
Korea. The proportion of women with careers increased 7.1%,
while the proportion of housewives decreased from 64.5% (343
housewives of 531 female subjects) to 57.4% (292 housewives of
24
508 female subjects) over the 5 years.
Several studies have reported that the prevalence of IBS is
aligned with household income and socioeconomic status. Gwee
35
et al. reported that there is a significantly higher prevalence of
IBS among those living on their landed property, as compared to
those living in apartments or public housing (16.8% vs. 8.2%, respectively) and among those with more than 6 years of post secondary education (9.8% vs. 5.9% ≤ 6 years). Other Asian studies reported the significantly higher prevalence of IBS in city than
29
in rural areas (10.5% vs. 6.14%), whereas another study showed
36-38
In the
IBS was no longer associated with educational level.
present study, subjects with higher household income have a significantly higher prevalence of IBS under the Rome II criteria.
We also found a significant correlation between the prevalence of
IBS and higher education level according to the Rome III
criteria.
In schematic presentation of subgroups according to the
Rome criteria, the proportion of subjects below 30 years old was
higher in group A than group B. As a result, the subjects in group
A are young enough to understand disease and to remember
more severe symptoms for a longer period, thus meeting the
Rome II criteria. Diagnostic criteria for IBS has evolved from the
Manning criteria although are still imperfect. Debate of the over
the Rome criteria with regard to timeframe and definition of severity continues, and subgroup characterization will be necessary
to improve IBS diagnosis.
One limitation of the present study need is a lack of survey
method diversity designed to improve response rate, as compared
32
39
to that of previous studies. Lau et al. and Masud et al. con-
Vol. 16, No. 2 April, 2010 (186-193)
191
Dong Won Park, et al
ducted a house-to-house survey and yielded a response rate of
over 90%. Documentary questionnaires had a somewhat higher
23,30,33
whereas the
response rate, ranging from 58.4% to 74.0%,
response rate of our telephone survey was relatively low (20.2%).
The relatively poor response rate could influence investigators to
omit ‘true’ IBS patients, although the sample had been selected
within the 95% confidence intervals, and the present study has
been validated. Another limitation of the present study is a lack of
inquiry about confounding factors. Previous reports revealed that
history of medication (analgesics, such as NSAIDs), food allergies, recent dysentery, psychological stress, and body mass index
36-38
were significantly associated with the prevalence of IBS.
In conclusion, the prevalence of IBS in the South Korean
population is 9.0% by the Rome III criteria and 8.0% by the
Rome II criteria. Using either set of criteria, female subjects tend
to have a higher prevalence of disease than male subjects. The
Rome III criteria are less restrictive than but show good agreement overall with the Rome II criteria in diagnosing IBS.
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